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Dyspnea in Community-Dwelling Older Persons: A Multifactorial Geriatric Health Condition.
Friday,2016-12-16 09:37 America/Los_Angeles — ecterry
| Title | Dyspnea in Community-Dwelling Older Persons: A Multifactorial Geriatric Health Condition. |
| Publication Type | Journal Article |
| Year of Publication | 2016 |
| Authors | Miner, B, Tinetti, ME, Van Ness, PH, Han, L, Leo-Summers, L, Newman, AB, Lee, PJ, Fragoso, CAVaz |
| Journal | J Am Geriatr Soc |
| Volume | 64 |
| Issue | 10 |
| Pagination | 2042-2050 |
| Date Published | 2016 Oct |
| ISSN | 1532-5415 |
| Abstract | <p><b>OBJECTIVES: </b>To evaluate the associations between a broad array of cardiorespiratory and noncardiorespiratory impairments and dyspnea in older persons.</p><p><b>DESIGN: </b>Cross-sectional.</p><p><b>SETTING: </b>Cardiovascular Health Study.</p><p><b>PARTICIPANTS: </b>Community-dwelling persons (N = 4,413; mean age 72.6, 57.1% female, 4.5% African American, 27.2% <high school education, 54.7% ever-smokers).</p><p><b>MEASUREMENTS: </b>Dyspnea severity (moderate to severe defined as American Thoracic Society Grade ≥2) and several impairments, including those established using spirometry (forced expiratory volume in 1 second (FEV1 )), maximal inspiratory pressure (respiratory muscle strength), echocardiography, ankle-brachial index, blood pressure, whole-body muscle mass (bioelectrical impedance), single chair stand (lower extremity function), grip strength, serum hemoglobin and creatinine, Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Mental State Examination, medication use, and body mass index (BMI).</p><p><b>RESULTS: </b>In a multivariable logistic regression model, impairments that had strong associations with moderate to severe dyspnea were FEV1 less than the lower limit of normal (adjusted odds ratio (aOR) = 2.88, 95% confidence interval (CI) = 2.37-3.49), left ventricular ejection fraction less than 45% (aOR = 2.12, 95% CI = 1.43, 3.16), unable to perform a single chair stand (aOR = 2.10, 95% CI = 1.61-2.73), depressive symptoms (CES-D score ≥16; aOR = 2.02, 95% CI = 1.26-3.23), and obesity (BMI ≥30; aOR = 2.07, 95% CI = 1.67-2.55). Impairments with modest but still statistically significant associations with moderate to severe dyspnea included respiratory muscle weakness, diastolic cardiac dysfunction, grip weakness, anxiety symptoms, and use of cardiovascular and psychoactive medications (aORs = 1.31-1.71).</p><p><b>CONCLUSION: </b>In community-dwelling older persons, several cardiorespiratory and noncardiorespiratory impairments were significantly associated with moderate to severe dyspnea, akin to a multifactorial geriatric health condition.</p> |
| DOI | 10.1111/jgs.14290 |
| Alternate Journal | J Am Geriatr Soc |
| PubMed ID | 27549914 |
| PubMed Central ID | PMC5073004 |
| Grant List | P30 AG024827 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States T32 AG019134 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States P30 AG021342 / AG / NIA NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States R56 AG023629 / AG / NIA NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States |
ePub date:
16/10